Kang L, Li YH, Li R, Chu QM. Predicting apical hypertrophic cardiomyopathy using T-wave inversion: Three case reports. World J Clin Cases 2023; 11(25): 5970-5976 [PMID: 37727498 DOI: 10.12998/wjcc.v11.i25.5970]
Corresponding Author of This Article
Qing-Min Chu, MD, Associate Chief Physician, Associate Professor, Department of Cardiovascular Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Jichang Road, Baiyun District, Guangzhou 510000, Guangdong Province, China. 13929504676@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2023; 11(25): 5970-5976 Published online Sep 6, 2023. doi: 10.12998/wjcc.v11.i25.5970
Predicting apical hypertrophic cardiomyopathy using T-wave inversion: Three case reports
Liang Kang, Yi-Hua Li, Rong Li, Qing-Min Chu
Liang Kang, Yi-Hua Li, The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Rong Li, Qing-Min Chu, Department of Cardiovascular Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Author contributions: Kang L and Li YH reviewed the literature and contributed to manuscript drafting; Li R and Chu QM analyzed and interpreted the electrocardiogram and coronary angiography findings; Chu QM was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Min Chu, MD, Associate Chief Physician, Associate Professor, Department of Cardiovascular Disease, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Jichang Road, Baiyun District, Guangzhou 510000, Guangdong Province, China. 13929504676@163.com
Received: May 22, 2023 Peer-review started: May 22, 2023 First decision: July 6, 2023 Revised: July 11, 2023 Accepted: July 31, 2023 Article in press: July 31, 2023 Published online: September 6, 2023 Processing time: 102 Days and 3.3 Hours
Abstract
BACKGROUND
Apical hypertrophic cardiomyopathy (AHCM) is a subtype of hypertrophic cardiomyopathy. Due to its location, the thickening of the left ventricular apex can be missed on echocardiography. Giant negative T waves (GNTs) in left-sided chest leads are the hallmark electrocardiogram (ECG) change of AHCM.
CASE SUMMARY
The first patient was a 68-year-old woman complaining of recurrent chest tightness persisting for more than 3 years. The second was a 59-year-old man complaining of spasmodic chest tightness persisting for more than 2 years. The third was a 55-year-old woman complaining of recurrent chest pain persisting for 4 mo. In all three cases, GNTs were observed several years prior to apical cardiac hypertrophy after other causes of T-wave inversion were ruled out.
CONCLUSION
Electrophysiological abnormalities of AHCM appear earlier than structural abnormalities, confirming the early predictive value of ECG for AHCM.
Core Tip: Apical hypertrophic cardiomyopathy (AHCM) is a subtype of hypertrophic cardiomyopathy that is thought to be associated with sudden death. Owing to its atypical clinical symptoms and insidious progression, early diagnosis is difficult. We followed up three patients who eventually progressed to AHCM over a period of several years. Giant negative T waves in the left-sided chest leads of these three patients occurred earlier than thickening of the left ventricular apex as detected via echocardiography. Therefore, we suggest that electrophysiological abnormalities in AHCM appear earlier than structural abnormalities and that electrocardiogram may have early predictive value for AHCM.
